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USA Today
College campuses drove major COVID-19 outbreaks. Now, will they require the vaccine?
Lindsay Schnell
André Le Duc doesn’t consider himself a fortune teller. As the
University of Oregon’s chief of safety and risks, Le Duc prides himself
on planning, often way into the future.
So when the novel coronavirus started to spread in China in early 2020,
Le Duc knew it wasn’t going away anytime soon. He told his university
administration to start planning immediately, and mentally preparing,
for a months-long, worldwide pandemic.
In a disaster situation, Le Duc said, timing is everything: “Every
minute you have, you need to be thinking two to three months out. … The
question we kept asking was, ‘What’s next?’”
Now, after nearly a year and the loss of close to 290,000 Americans, what’s next is a vaccine.
The first doses of the COVID-19 vaccine are expected to be administered
to Americans as soon as this weekend. States are prioritizing frontline
health workers and other vulnerable populations as the first to be
immunized, but colleges like the University of Oregon are also front of
mind. After all, college students fueled some of the nation's top
outbreaks this fall, and they're expected to return to campuses early
in 2021.
Will they – can they – be required to get the vaccine once it's readily
available? And why are college students different than schoolchildren?
It's complicated, education experts across the country say – and we're a long way from answers.
Vaccine not available to younger students
Because the vaccine was not tested on children, elementary, middle and
high school students won’t be required to get one, at least for the
foreseeable future. Most states require at least some vaccines for
public school students, but states vary widely on allowable exceptions.
Teachers and staff members could be a different story.
A coalition of top education stakeholders, the Learning First Alliance,
has argued prioritizing school personnel – teachers, administrators,
classroom aides, and custodial workers – is key to reopening schools.
But Richard Long, the executive director at Learning First, stopped
short of saying school staff should be required to get the vaccine.
“It’s not a black and white issue,” he said. “It’s not like teachers
surrender all their rights to make their own decisions when they become
teachers.”
Some elected officials have already said they won’t require
vaccination, including Tennessee Gov. Bill Lee and New York Mayor Bill
de Blasio.
Regardless of whether they eventually require the vaccine, America's
schools have a huge role in the rollout, said Laurie Combe, president
of the National Association of School Nurses.
"It's our role as school nurses to educate the public," she said. "When
students don't receive the immunizations they should, that creates a
problem not just for the school, but spread in the larger community."
College students should be vaccinated – but when?
At colleges, the dilemma is different. Their students can be vaccinated
– but it's unclear when will there be enough doses available for them.
“There are so many hurdles in place before we have this vaccine out
there,” said Michael Baughman, a Philadelphia lawyer who works with
colleges on compliance with state and federal laws. “Even if colleges
wanted to mandate it, we’re not going to have the supply to do that
until at least the next (2021-22) academic year.
“States might pass laws at some point that do mandate it – but we’re a long way from that even being practical.”
Then there's the issue of how colleges would even administer a vaccine.
The American College Health Association has not made a decision about
whether colleges should require the COVID-19 vaccine – it's waiting for
guidance from the Centers for Disease Control and Prevention . But
Gerri Taylor, the ACHA’s COVID-19 co-chair and a nurse practitioner,
has concerns about vaccine rollout, regardless of whether it’s mandated.
“Many colleges still don’t have enough supplies or staff to do testing
regularly,” she said. “If you can’t even get a test, how are you going
to get a vaccine?”
It's important for colleges to have their own vaccination plans. Many
low-income students lack regular access to health care or financial
support from their family, so they'd need a place to get the shot.
The vaccine dose itself will be free, the federal government says.
Providers could charge an administrative fee to pay for people to
administer the shot, but the CDC says this will be reimbursed by the
federal government or private insurance.
But the logistical issues – from staffing to storage to space to hold vaccine clinics – are significant.
Le Duc at the University of Oregon knows firsthand about those
potential barriers. Almost six years ago, in February 2015, a
meningitis B outbreak at the Eugene campus left one student dead – and
administrators like Le Duc with lessons they can apply today, as
coronavirus continues to infect millions of Americans.
Fighting misinformation will be crucial
Meningitis B is rare, but deadly. While there’s a vaccine available,
the CDC doesn’t widely recommend it for college students. According to
the Meningitis B Action Project, even though people ages 16 to 23 are
more likely to get it – and college students are five times more likely
to get it – only 41 of the nation’s more than 5,000 colleges and
universities require the vaccine for students.
The University of Oregon is not included in those 41, despite the 2015
outbreak that left one student dead. (In Oregon, the measles vaccine is
the only shot required statewide for college students, though the
flagship university mandates a few others). But the college did
immediately open vaccine stations around town in 2015, encouraging
students to get the meningitis B vaccine, as the CDC typically
recommends after campus outbreaks.
Their biggest lesson in the aftermath of that outbreak was twofold, Le
Duc said. First, officials quickly understood “the seriousness of just
how fast these things can move. We only had one fatality, but that
person went, in just 24 hours, from feeling healthy and well to being
deceased.”
Second, they learned how critical it is to get information to students
as soon as possible, ideally before mass misinformation can spread.
When the meningitis B vaccine was made available to UO students, rumors
circulated that it was extremely expensive, and getting it would
cripple students’ finances. Le Duc called it a "misstep" he wishes they
could take back.
“Even though that wasn’t true, even though we’d negotiated a deal, we
fought that (misinformation) the whole time,” Le Duc said. “We kept
asking people where they heard it, and they said it was word of mouth.
… We’re in an environment now that there’s so much information, what
information are you going to trust? Usually it comes down to casual
conversations because, generally, we trust the people we love.”
Le Duc and others noted the power of influential campus figures – like
the football team’s star quarterback or student government president –
when it comes to normalizing vaccines. Don’t underestimate, he said,
how students might react if every member of the football team is
walking around with a colorful bandage signaling they got a shot; it
could very well lead to more students deciding to get the vaccine too.
Still, there are worries. Some of the vaccines will need to be stored
in extremely cold freezers, and not all schools will have access to
those, especially if they’re not research institutions. Along with
barriers such as staffing and whether the vaccine will be widely
available, there are also questions about how long immunity will last,
and if a new shot will be required each year, like with the flu. (Some
colleges require students to have the flu vaccine.)
Because universities often set up flu vaccine clinics around campus and
the local community, colleges will have a rough game plan they can
follow with COVID-19 vaccines, said Debra Beck, the executive director
of the University of Oregon's health services. But they'll absolutely
need more resources.
"We would need to be supplemented," she said. "Physically we don't have enough people" to administer the vaccine.
Students say colleges have 'responsibility' to protect campus
Peer pressure, experts say, is real. That's why colleges that have
normalized COVID-19 safety precautions like mask-wearing and social
distancing haven’t just helped their campus, but their community at
large, said Taylor at the ACHA.
At Lawrence University, a small liberal arts college in Appleton,
Wisconsin, the school’s homepage features a collage of students and
staff all wearing masks. They’re promising to “honor the pledge,” which
means agreeing to wearing masks indoors, maintaining safe physical
distances from other individuals and getting a flu shot, among other
measures.
Chau Q. Le, 22, is a senior international student from Vietnam studying
biochemistry at Lawrence. She’s set to graduate in the spring and hopes
to be enrolled in graduate school next fall. She also hopes wherever
she goes, the university requires the COVID-19 vaccine.
"If you think about it, college campuses are one of the easiest places
for the virus to spread, because of how densely packed they are," Le
said.
But she understands there's a lot about the vaccine the general public
doesn't know or understand, which makes some people leery to trust it.
UCLA student Naomi Riley agrees and says it’s on universities to break
that barrier.
“As a research university, as the No. 1 public university in the
country, we have a duty to educate folks on campus and in our
communities in a way that reaches them and compel them to get this
vaccine,” said Riley, a fourth-year political science student and
president of the Undergraduate Students Association Council.
As a Black woman who grew up 30 miles north in the San Fernando Valley,
Riley understands why communities of color have expressed particular
skepticism about the vaccine and vocalized their hesitation in getting
it.
“Communities of color have long been betrayed, and medical racism is
real,” Riley said. “We have to validate those feelings and acknowledge
that very real history.”
Riley plans to get the vaccine when it’s available. And even though
she’ll likely have graduated by then, she believes colleges have a
responsibility to their larger community and should require the vaccine.
“I definitely think the mandate should come from the state first,” she
said. “But I think the next best thing is a university, because
colleges have a duty to make sure their students are safe on campus.”
College students feel defeated right now, she said. “We were robbed of
our senior years, and it’s just so disappointing that our government is
so reactionary rather than being proactive.”
A vaccine mandate, as she sees it, would be proactive in the best way possible.
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